• Posted July 6, 2023

Hepatitis C Treatments: A Comprehensive Guide

Did you know the U.S. Centers for Disease Control and Prevention estimates that there were nearly 68,000 new cases of acute hepatitis C in 2020 and over 107,000 newly reported cases of chronic hepatitis C?

To help you better understand how to manage this viral infection of the liver, here, experts reveal the most common treatments for hepatitis C — including antiviral medications, lifestyle changes and surgery — plus, how these treatment options work to manage the hepatitis C virus (HCV).

Hepatitis C medication treatments

According to the CDC and Hepatitis C Online, there are several different antiviral medications used to help treat hepatitis C, including:

• Elbasvir-Grazoprevir (Zepatier)
• Glecaprevir-Pibrentasvir (Mavyret)
• Ledipasvir-Sofosbuvir (Harvoni)
• Ribavirin (Copegus, Moderiba, Ribasphere)
• Sofosbuvir (Sovaldi)
• Sofosbuvir-Velpatasvir (Epclusa)
• Sofosbuvir-Velpatasvir-Voxilaprevir (Vosevi)

Dr. Melissa Jenkins, chief of the division of infectious diseases at MetroHealth Medical Center in Cleveland, Ohio, noted that “sofosbuvir-velpatasvir (Epclusa), glecaprevir-pibrentasvir (Mavyret) and sofosbuvir-velpatasvir-voxilaprevir (Vosevi)… are the most common.”

The CDC says that these hepatitis C medications have a 90% cure rate when taken for 8 to 12 weeks.

According to the Liver Foundation, antivirals are usually prescribed for chronic hepatitis C (which lasts 6 months or more), although they may also be used for acute (short-term) infections. They work by clearing the virus from your bloodstream and slowing down inflammation and scarring in your liver.

The Liver Foundation also suggests getting vaccinated for hepatitis A and hepatitis B if you have hepatitis C, to avoid the risk of a coinfection.

Non-medication hepatitis C treatments

“The number one thing to protect the liver in hepatitis C is to avoid alcohol. There is no safe amount of alcohol for someone with hepatitis,” Jenkins advised.

In addition, the Liver Foundation says to make sure you get plenty of fluids and rest and eat a healthy diet. Combining these strategies may often clear up an acute hepatitis C infection without medication.

It also recommends seeing your doctor regularly for blood tests to monitor your HCV levels.

Since sharing needles or other drug paraphernalia is one of the ways people get hepatitis C, Jenkins also suggests seeking help for substance use if you are receiving treatment for hepatitis C, to avoid reinfection.

“If patients are unable to stop using drugs, there are ways to make injecting safer, such as using a syringe service program needle exchange and not sharing needles or drug paraphernalia," she explained.

Hepatitis C surgeries

Since hepatitis C that's left untreated may lead to a number of debilitating health conditions like cirrhosis (liver scarring with permanent damage), liver cancer and liver failure, the CDC says it's the number one reason for liver transplants in the United States.

“When most people think of cirrhosis, they think of alcohol as a cause, but hepatitis C can lead to cirrhosis even in non-drinkers,” Jenkins said. “People with cirrhosis have a lot of scarring (fibrosis) in the liver, which can lead to liver failure... cirrhosis also makes people susceptible to liver cancer. Once cirrhosis develops, it is irreversible.”

This is a key reason why people with chronic hepatitis C should have regular check-ups to ensure antiviral medication is effective. According to NYU Langone, if your liver is damaged to the point of failing, liver transplant surgery may be necessary.

During the procedure, a partial liver from a donor with the same blood type and liver size as you is transplanted, and your damaged liver is removed.

Surgery for liver cancer may also be necessary for people with hepatitis C, to remove the cancerous section. This allows the regrowth of healthy tissues, sometimes in as little as 4 to 6 weeks.

Optimizing hepatitis C treatment

The sooner you know you have hepatitis C, the faster you may get treatment to help reduce your risk of liver damage. The CDC recommends getting tested once upon turning 18, as well as if you:

• Are pregnant
• Use or have used drugs
• Have liver conditions
• Are HIV positive
• Have been exposed to the blood of anyone infected with hepatitis C
• Received clotting concentrate factors before 1987
• Had organ or blood transfusions before July 1992
• Were born to a mother with hepatitis C

“Getting rid of hepatitis C can help slow down or prevent advanced complications,” Jenkins advised. “Treating patients earlier, before they get cirrhosis, can prevent it from developing.”

SOURCE: Melissa Jenkins, MD, infectious disease specialist, MetroHealth, Cleveland, Ohio